Major hip and knee joint replacement or reattachment of lower extremity without major complications in Rhode Island
What 3 hospitals in Rhode Island charged and were paid for a Medicare hospital stay for major hip and knee joint replacement or reattachment of lower extremity without major complications (DRG 470), from 2024 Medicare claims.
Average charge
$33,721
Hospital list price billed
Average payment
$16,805
Medicare + patient + other payers
Medicare paid
$14,820
Average per stay
State rank
#34 of 48
1 = lowest average payment
Hospitals in Rhode Island billed an average of $33,721 for major hip and knee joint replacement or reattachment of lower extremity without major complications, about 2.0 times the average total payment of $16,805. That payment is 3% below the U.S. average of $17,318.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $16,805Billed $33,721
About 50¢ was paid for every $1 hospitals in Rhode Island billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Rhode Island:
Rhode Island hospitals: major hip and knee joint replacement or reattachment of lower extremity without major complications
Every Rhode Island hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Miriam HospitalProvidence | 161 | $31,533 | $17,627 | $15,662 |
| South County Hospital INCWakefield | 51 | $41,161 | $14,859 | $12,652 |
| Newport HospitalNewport | 18 | $32,210 | $14,973 | $13,432 |
Lowest and highest payments in Rhode Island
Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| South County Hospital INCWakefield, RI | $14,859 |
|---|---|
| Newport HospitalNewport, RI | $14,973 |
| Miriam HospitalProvidence, RI | $17,627 |
Highest
| Miriam HospitalProvidence, RI | $17,627 |
|---|---|
| Newport HospitalNewport, RI | $14,973 |
| South County Hospital INCWakefield, RI | $14,859 |
Major hip and knee joint replacement or reattachment of lower extremity without major complications in other states
Questions
How much does major hip and knee joint replacement or reattachment of lower extremity without major complications cost in Rhode Island?
In 2024 Medicare data, a hospital stay for major hip and knee joint replacement or reattachment of lower extremity without major complications (DRG 470) at 3 hospitals in Rhode Island was billed at $33,721 on average, while the average total payment was $16,805, of which Medicare paid $14,820. Your own cost depends on your insurance, deductible and the hospital.
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in Rhode Island, average charges were 2.0 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.